Tamar D Kritzer, Kaylee White, Meaghan Maynard, Anil Palanisamy, Ben Bahrami, Dylan Kobsar
Anterior cruciate ligament (ACL) injuries represent one of the most common and disruptive conditions in sport. Effective return-to-play (RTP) monitoring requires multidimensional approaches capturing physical, psychological, and sport-specific components rather than reliance on isolated benchmarks. This study aimed to longitudinally examine the RTP process of a female varsity basketball athlete following ACL reconstruction, using a framework integrating physical performance (capacity), biomechanical sport-specific (capability), and psychological (confidence) components relative to pre-injury benchmarks. Data collection included countermovement jump testing with force plates, on-court inertial measurement unit (IMU) monitoring of limb-loading, and psychological questionnaires, analyzed relative to the athlete's pre-injury baseline, with post-surgical change interpreted against that individualized reference using minimal detectable change thresholds. Pre-injury monitoring indicated stable movement profiles with minor fluctuations. Following ACL reconstruction, jump height recovered within seven weeks of RTP initiation, but notable inter-limb asymmetries persisted in force plate and IMU measures despite high confidence scores. Symmetry improved over time, yet variability in on-court loading remained after clinical clearance. These findings highlight the value of integrated, multidimensional monitoring to detect residual deficits that may be overlooked by traditional outcome-based assessments. This study demonstrates that integrating athlete-specific biomechanical, psychological, and sport-specific assessments relative to pre-injury baselines can support RTP decision-making to enhance individualized recovery trajectories in female athletes.